The role of the state in protecting public health (an important value) while also encouraging economic development (another important value) is an interesting example of the multiplicity of values or interests at stake in public policy, that can sometimes come into conflict. Classic examples include controlling gambling (state lotteries, casinos, slot machines), and the sale of alcohol (e.g., through state/provincial liquor stores) or cigarettes, cases where the state’s responsibility to prevent or discourage unhealthy behaviour in the name of public health (usually within the scope of a Ministry of Health) comes up against a strong interest in the important tax revenues generated by the sale of these legal (but somewhat dangerous) products. While public health has an increasingly prominent place in public policy, it would hard not to be somewhat cynical about the predominance of economic interests (tax revenue) in government decision making. But such differences in values or interests do not, in and of themselves, constitute formal COI. For COI to be an issue, there needs to be more direct influence on the objectivity of decision makers…
Issues of state policy:
Issues about research:
P.S. June 7, 2011:Gov’t in conflict of interest over tackling smoking (Malaysia) and
Anti-Tobacco Campaign Heats Up in China Despite Conflict of Interest Among Administrators (China)
There’s been a lot of rumbling over the last few months about possible COI on the part of the WHO in their handling of the recent H1N1 “pandemic”. Specifically, concern has been raised that the some of the senior scientists involved in the development of the WHO pandemic guidelines were influenced by the pharmaceutical industry. This issue came to a head with a recent June BMJ editorial “WHO and the pandemic flu ‘conspiracies‘”. Of particular concern is that the WHO did not disclose the COI of the key authors involved in preparing the pandemic guidelines, even though these interests where disclosed to the WHO by the authors.
See also the following news stories:
And the WHO’s response to the BMJ editorial:
The following book review from the New York Times of Daniel Greenberg’s “Tech Transfer“ suggests some fun summer reading on university COI:
“Tech Transfer” is the deceptively mild title of a mordant satire about scientists and universities and how they do business. The best scene in this hilarious first novel is a meeting of the trustees of Kershaw University, an elite research university only 200 years younger than Harvard. The trustees have to select a new president. They listen with mounting dismay as the professional headhunter in charge of the search reads out the polished résumés of each candidate, but notes in each case the fatal flaws revealed by background checks, ranging from spousal abuse to bestiality and, even more fatal, plagiarism.
As the trustees hasten to leave for the airport, they agree on a nonentity, Mark Winner, an economics professor with a thin résumé and a clean rap sheet.
From the Pharmalot blog, NIH Proposes New Rules For Researcher Conflicts
In a bid to restore public trust, the National Institues of Health has proposed new rules that would require academic researchers who receive agency funding to more thoroughly report any financial conflicts of interest, and also require institutions – such as universities – to do a better job of gathering this information and then forwarding it to the NIH. This includes posting info on a web site…
P.S. June 2. See also: The Vexing Problem of Guidelines and Conflict of Interest: A Potential Solution
Two recent stories on COI in the context of US government health research advisory committees caught my attention.
1) FDA to Broaden Disclosure on Advisers’ Conflicts of Interest
- In a move to redress some of the major concerns about COI on the part of researchers who serve on Food and Drug Administration (FDA) advisory committees (e.g., researchers with pharma or medical device industry ties), while accepting that some COI may be inevitable (e.g., because there are only a few expert researchers and they all have financial interests) the FDA is proposing new guidelines dealing with the public declaration of financial interests.
2) Senator pushes CDC to disclose experts’ conflicts
- in a similar vein, attention is being brought to bear on the Centers for Disease Control (CDC) and their handling of COI on the part of expert researchers giving advice to the CDC committees.
In both of these cases, the issue is about ensuring that the topmost government health agencies — which seek advice from the academic research community in setting policy or making funding decisions — do so in a manner that recognise the interests of the parties involved, and put in place mechanisms to manage any conflicts.
P.S.: Dec 20, 2010: See this commentary by Chris MacDonald Conflict of Interest in the PMO: Just What is the Worry?, which gives a nice description of the major perception problem of COI when industry members work with government.